Temporomandibular Disorders (TMD) represent a collection of medical and dental conditions affecting the temporomandibular joint (TMJ) and/or the muscles of mastication, as well as contiguous tissue structures. For some patients with severe TMJ degeneration, a prosthetic replacement may be required. However, long-term success and functioning of current implant designs remains a serious problem due, in large part, to the deterioration of the implant and surrounding tissue resulting from wear debris. During Phase I of this project, the UAB and Vista Engineering team developed novel nanotechnology diamond coatings with enhanced adhesion and wear properties for articulation components in TMJ devices. This new technology will be used in the proposed Phase II to enable new total replacement TMJ prostheses of smaller size and longer life. The smaller sized prosthesis designs will enable minimally invasive clinical pathways targeted for a single-incision implantation. The new TMJ prostheses will be designed using finite element modeling and analysis to minimize the device size based on the use of nanostructured diamond on the articulating surfaces. The prototype designs will be manufactured and tested in a TMJ, mandibular wear simulator. Successful designs will be carried to clinical translation studies using a miniature pig animal model. Commercialization potential for the product will be developed through prosthesis design, prototype wear testing and clinical translation. Letters of support for this Phase II project have come from biomedical and venture capital companies in support of our commercialization plan. UAB and Vista Engineering have a strong track record of collaboration culminating in the licensing (to Vista Engineering) of a UAB patent involving this technology: "Process for Ultra Smooth Diamond Coating on Metals and Uses Thereof", Patent # 6,183,818. Our specific aims are as follows: Specific Aim 1: Optimize New Designs for Minimally Invasive TMJ Total Replacement Prosthesis by Computer Modeling and Analysis. Specific Aim 2: Manufacture Prototype Prostheses of Promising Minimally Invasive Designs. Specific Aim 3: Rank and Revise Computer-Optimized Designs Based on Test Results from Mandibular Wear Simulator Specific Aim 4: Conduct Clinical Translation Studies on Two Most Promising Designs PUBLIC HEALTH RELEVANCE: We propose the use of a nanotechnology approach, using nanostructured diamond for controlling interfaces between Temporomandibular Joint (TMJ) implants and the surrounding tissues, to improve the fixation, durability and osseointegration for long-term implant success. As many as 60,000 Americans could benefit from the nanostructured diamond-diamond components that will facilitate reductions in implant device size and enable a clinically less- invasive route to joint restoration. We also propose a clear pathway for commercialization of the nanotechnology enabled TMJ prosthesis.